Cardiac Rehab

Definition

Rehab of a variety of heart conditions such as

o CAD most prevalent
o MI
o Heart failure
o Valvular dysfunction
o Arrythmias
*define each

Anatomy

Surface anatomy
o Angle of Louis jxn of manubrium & body
o Base bet 2nd & 3rd rib
o Apex 5th rib
o 2nd ICS
R aortic valve
L pulmonic valve
o 4th CC
R mitral valve
L tricuspid valce
Layers of the heart
o Endocardium
o Myocardium
o Epicardium/visceral pericardium
o Parietal pericardium
Coronary arteries
o Left Main
LADDiagonal
CircumflexMarginal
o Right Coronary Artery
Posterior Descending Artery
Conduction System
CO
SV
EF
LVEDV
RPPMVO2

Etiology

Atherosclerosis accumulation of lipids, monocytes, platelets.

Debris
Risk factors
o DM
o Smoking
o Obesity
o Stress
o Male
o Age
Coronary Spasm

Epidemiology

Heart disease is leading cause of death in US

Atherosclerosis MC cause of CAD

Pathophysiology

Injury to the intimainflammatory reactionplatelets adhere to

wall, binding of substancesnarrowing of vessel
CADMICHF

Clinical Manifestation

Ischemia 70%
Angina pectoris
o Grading
o Types
Dyspnea
o Grading
Infarction
Palpitations
Cough
Fatigue
Claudication
Cardiopulmo
o Cyanosis
o Clubbing
o Diaphoresis
o Edema
L & R heart failure

Diagnosis

History
PE
o BP
HTN classification
o Pulse
Grading
Location
o Auscultation
ECG
ETT
Lab works
o Values
Cardiac enzymes
2d-echo
Left heart cardiac catheterization

Medical Management

PTCA
CABG
Heart transplant
Drug
o Digitalis
o Diuretics
o Ca channel blockers
o Beta blockers
o nitrates

PT Management